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1724 Hickory HillCITY OF FAGAN Remarks - Addition • WOOd ate 2nd Lot 3 Bik 2 Parcel t0 846o1 030 02 Owner ? Street 172 L H1CkoX'v Hill State ESgan.,TRNT 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 2 1 .11 1.02 Paid STREET RESTOR. 1? fj 22.27 1 Q.76 3 Pa;id GRADING SAN SEW TRUNK 1974 99. 2 6.63 1 Paid ? SEWER LATERAL 1976 1871.09 623.70 P11.d 3(- WATERMAIN WATER LATERAL 1976 # WATER AREA 1976 -? STORM SEW TRK 1976 3 # STORM SEW LAT 1976 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 14000 12109 11-8-74 9UILDING PER. sa,c 00.00 1210 -8-74 CITY OF EAGAN Remarks .., . ?_.___r,n- t-, c.- ?.:?-? ? ....? - Improvement Date Amount Annual ears Payment Receipt Date STREET SURF. 11 1.02 STREET REgTVR,. ? 422.27 1ho 6 P3id GRADING SAN SEW TRUNK ' 1 2 6.6 1 Paid SEWER LATERAL /' 1 J WATERMAIN * WATER LATERAL 1976 WATER AREA 1976 3 * STORM SEW TRK 1976 * STORM SEW LAT 1976 CURB & GUTTER 51DEWALK STREET LIGHT WATER CONN. 140.00 1210 11 -8-74 BUILDING PER. sAC 00 00 1210 11- -7 PAR K CITY OF EAGAN Remarks Addition Lot 2 Bik 4 Owner ? Street 1728 Hickorv Hi l l Improvement Amount Annual Years Payment Receipt Date STREET SURF. 11 1.02 P?C? STREETR? 22.27 1?,Q.7fj 3 Paid GRADING ff SAN SEW TRUNK 99??2 6.63 15 P?d .}? SEWER LATERAL ' ?a 97 ?.0 2.70 Paid WATERMAIN # WATER LATERAL 1976 3 # WATER AREA 1976 3 dE STORM SEW TRK 197 3 # STORM SEW LAT 1976 3 CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 140.00 1210 11-8-7 6UILDING PER. sac 00.00 12109 1 -7 PARK CITY OF EAGAN Remarks Addition Wood ate 2nd Lot 1 eik 2 Parcel Owne d4. ALL 1-JIL ?1 Street 1730 Hickorv Hill State }'agan;MN 551PP 10R nD. ??:t?nno.?.C -??,u,E AV :(: i 1 ? Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 1974 .11 1.02 STREET R_ ? 1976 22.2 14o. 6 P21d GRADING SAN SEW TRUNK Cl,'I j 1 99. 2 6.6 1 Pa1d * SEWER LATERAL 1976 18 1.o 623.7 ? Pi WATERMAIN # WATER LATERAL 1976 # WATER AREA 1976 ib STORM SEW TRK 1976 3 # STORM SEW LAT 1976 CURB & GUTTER SIDEWALK STREET LlGHT WATER CONN. 1 O•00 12109 11-8-711 BUILDING PER. sac 00.00 1210 11-8-74 CITY OF EAGAN PERMIT TYPE: 'M" 11' INti ' 3830 Pilot Knob Road Permit Number: Ea an, Minnesota 55122-1897 ti? F. /?}? ?.+F a 9 Date Issued: , (612) 681-4675 ? ? SITE ADDRESS: 'N ' 1 " "' "f, 0 0" APPLICANT• r a f;t I I Ir . • ?. ??. IirClK UkY Fltl.l ')t 14Wic-f'•? 1Mr. ? 1l??uU??il I{ .'Nfl :',fd-481b ; PERMIT SUBTYPE: i I..! R„' I IicttlriN 114 TYPE OF WORK: ? iaf r?:?pTar?ra ? ; f I {'rl 1 1iAS 1_ (NE 1?. 1 N•,F?t= f?', F IHAI F Psrmlt No. Permit Nolder Date Telephone # ELECTRIC PLUMBING HVAC Inspec:tion Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYPBOARD FIREPIACE FIREPLACE AIR TEST ?9- FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSM7 FINAL DECK FTG DECK FINAL YILlAOE 329i S'M' Eagan, M Zaning: Owner: Address Site Adc Plumber: mhomnson lumhina Co Meter No.: Connection Charg^ti:o-?--2?,- Size: Account Deposit Reader No.: Permit Fee: 10.00 od - 1 agrea to eomply wit6 the Villa9e ol Eogan Surchatge: .50 d. Misc. Chazge Ordinancef. Tolal: BY Date Paid: u Date of Insp.: Insp.: SEWER SERVICE PERMIT yILLAOE OF EAOAN ' 3795 ?IotKnobRoad 39d PERMIT NO.: 115/7?1 Eagan. MN 55125 DATE: Zoning: PUD No. of Units: W ate II ood Owner: ? Addmss: il l Site Address: 1794-26- Plumber: o. I pyna to eomply with fM Vilb9 * of Eagan Connection Charge: -100 ' Accoun[ Deposit: ------ Ordi"nus. 1D.00 pd Permit Fee: •50 pd Surcharge: Misa Chazges: By: Date of Insp.: Total: Date Paid: Insp.: OF EAGAN WATER SERVICE PERMIT 0 Knob Rood PERMIT NO.- 1638 N 53124 DATF.: 11/15/74 PUD No. of Units: CITY of EAGAN RUILDING PERMIT Ownes ....... ...... /4`.V......................... Addsecs (presenS) Builder Addsau c.? . . No 3480 3795 Pilo1 Knob Road Eagan, Minaesola 55122 954-8100 Dale ......f?..-.?_?::. ...?.`?..?....... Sloriss To Be Used Fos Fson! Dapth Haighf En2. Cosf Permi! Fae Remuko Slreel. Roed or olher DESCripilon of LoeaSlon I Loi 751oeB KCCU1on or 'lraa ) 7 -?-`y. This permii does aot au2horize the use of slreefa, roads, alleps or sidewffiks nos does it give the owaer os his agea! the righ! !o ereate anp siiuaSion whieh is a nuisanee or whieh presenta a hazard !o !6e haellh, eatalp, oonvenienea and general welfare fo anpone in the communily. THIS PERMIT MUST BEry? ?E,PT? ?O?N THE PREMISE WHILE THE WORK IS IN PROGIiE$S. ? T6is is !o ceri3fy, lhai..._...:.._...... ?..-----has permission !o erec! a...?.._?....:':`..?.....r/?..... _npon the above described pxemise subjecf Yo ihe provigions of all applicable Oxdinances for the Ciip of Eagaa (.? ? '°................°°°.............. .........°------....-°°-°-------.1.:1..`.Y..----Q0..-.?"..'.r'....... Per ..................... ..^!.....-.......?.....----... O........ Ma or n Building Inspector vC? czTY or EV]A;a 3795 Pi1ot Knob Rozd Eagan, Alinnesota 55122 PERPJIIT NO.: 601 The Cit3 of Eagan hereby grants to Geo. Sedgwick Heating & A/C Oo. o° 1001 Xenia Ave. So., Mpls. 55416 a IiEATING Permit•ior: (Owner) NeN HOrizon - Woodgate II 4545 Johnny?e, 1706 & 1728 Walnut Cirele and i at 1724-26 8 30 ffiakory eil4 pnrauant to application dated 10/31/74 , Fee Paid: $140.00 dai:ed thia 19th day of Nov. ? 19 3.50 a/c Building Inapeeter b`?c::a;:ical Permits: EiO! T::tal: ?1, A HOUSE HEATING TEST RECORD ADDRESS179.4 Nirknrv Hill OCQIPANT - HEAT LO55 - SOLD BY Elechical Work By TYPE OF HEAT DATE HTG. INST. GA _ FA ° HW STEAM D-21477 ?'?'? 3 - 2- J?{ p ? Eagan APT. ???NeL1YO ri0rizona?TM SUBURB OWNER _INSTALLED BY Sedgwick Htg. n +e _Gas Lina By SPACE HTR. -UNIT HTR. OTHER ' GAS DESIGN Willi8maOti MAKE MAKE OF BURNER _ Modal - 7-5 Model Serial Ma:. BTU Roting- INPUT 75 p 000 u MAKE OF FURNACE Model CONVERSION CONTROLS Cm 260 i? ? THERMOSTAT Heat PI Vsnt Size ? %u0c - um Valve , ' SIZE NONE KIND OF LINER Limit •' • a Droh Hood er 1C8 Rsgula.or ? Limit SsMing 900 ?umber Filtera $iz?? Fan Setting f `£ ide Chimney Location Inside Qa 0qis Ou e 9 ?Q?Q9L0 ` Pilot Type P; Y Chimney Construction Pilot Make Pilot Model Smoke Bomb Wiring Pilor Timins 75 ecori B DraFr Test Tag e8 L.W. Cut Off Door Pressure LighHng Insf. YQ8 Preasure 4.3"{V,r'. psrcentCO g•olfo 2 Dote Tested 2185/75 InpufCFH 7? Peresnt 0 7•? 2 CompanyTesfing C.S. B 1 Il't CO. ? "? Stack Temp. Percent C0 Name o{ Testar Form 235 HOUSE HEATING TEST RECORD D-21477 ADDRESS 1726 $1Ck0Y'y $111 APT.-FLOOR CITY SUBURB Eai°'9ri , OCCUPANT None OWNER N¢W HOI'7.zo118 HEAT 1055 DATE HTG. INST SOLD BY Elaehicel Work By TYPE OF HEAT / INSTALLED BY SEdgwlCk $tg, Gas Line By GA _ FA _HW -STEAM -SPACE HTR. UNIT HTR. _OTHER DE51GN GAS Williame on MAKE MAKE OF BURNER_ Model 1117-07-5 Model Sxial 7439307 Max. BTU Rating - INPUT 75,000 BtU AiX'. MAKE OF FURNACE CONTROLS THERMOSTAT Cm 260 Heat Plug Valva M.H. V8OOC Limit Robshaw RPL 750u Limit Setting 200°f + Fao s,rrioy 900f & 1200f Pilor Type Couple Pilot Make Model Vent Size KIND OF LINER A]L SIZE R" NONE Draft Hood VePtical Rsguloror Filters Size 7611 x 25" Number 7 Chimney Locotfon Inside Ye8 Outside Chimney Construction Metalbeatoa Pilot Madel Smoke Bomb Wiring Pilot Timing 69 ¢CO? B Dra{} OK Tezt Tag Yeg L.W. Cut Off Door Pressure Lightirtg InsT. Ye8 Pmssure 4,3°W,C• pefCQntCO 7,O?i Date Teated 2/19/ / 75 t CFH I 75 2 Peree t O $ 7 Testin an Com s C IGA C . npu n Z y g p q $tack Tem ? Percent CO ??? Name oF Tester ? y 7 ;{ yY p. Form 235 CONVER5ION ?-ct ! E? ,?1?'. ,•? _ :z HOUSE HEATING TEST RECORD D-21477 ADDRESS 1728 HiCkOry Hill APT. - FLOOR CITY SUBURB EAGAN OCCUPANT None nwNFp New Horiaons. HEAT LO55 DATE HTG. INST. SOLD BY INSTALLED BY -5eugwicx nc Elactrical Work By Gaa Line By TYPE OF HEAT GA _ FA X HW -STEAM -SPACE HTR. _UNIT HTR. -OTHER ? GAS DESIGN CONVERSION MAKE Will'.iamsn MAKE OF BURNER Modal - Model Sxial Mex. BTU Rating- INPUT ? B u MAKE OF FURNACE Modsl Cm ?60 CONTROLS THERMOSTAT •?• Heat Ply,g??- Valve M Yt5 Limit M.H. I.4064a Limit SaMing 200f Fan settin9 900f & 1200f Pilor Type Coup?e Pflot Make v,m s:e 4" KIND OF LINER Alum. SIZE 6" NONE Draft Hood Vertical Reguloror Filters Sizs 16i' x 25" Number 1 Gifmney Locotion Inside Ye9 Outside Chfmney ronsirucfion Metalbestos Pilot Model Smoke Bomb Wiring Pilot Timing 56 $BCOIIaB pra{t oK Test Tag BQB L.W. Cut Off Dou Preasure Liqhtin9 insr. Yes Pressure 4,3°VV,C, PercentCO 7•0% Date Teated 245'(5 CFH I Y 75 P f D 8 7 Co an TesTin nput ercen Z g mp y Stack Temp. 440of pereent CO ???, Name oF Tester F«m 235 I HOUSE HEATING TEST RECORD D-21477 ??l?? ???- a- ADDRESS 1730 Hickory Aill APT.-FLOOR CITY SUBURB Eag9t1 OCCUPANT None OWNER NewHOTizOt18 HEAT LOSS DATE HTG. INST. SOLD BY Electrical Work By Gas Line By TYPE OF HEAT GA _ FA X HW _STEAM -SPACE HTR. ? GAS DESIGN MAKE WilliamsonE MAKEOF BURNER Model 1117-07'5 Model CONVERSION lzsi a uai.i Serial Max. BTU Roting- INPUT 75,000 Bbu MAKE OF FURNACE Model CONTROLS THERMOSTAT C'wX 260 Heaf pIu yaM Size 411 Valve M•A. ?OVC KIND OF LINER Alum• SIZE 8?? NONE Limit ?0?a M'H Droh Hood vexilCe]. Regulator Limit Setting g 200 f Filtars Size 16"% 251' Number 1 Fan Selti?g 90 f& 120 f Chimney Location Insida Ye8 Outaida Pilot Typa OllPle Chjmney ConatrucYi on M@ta1b08 t08 Pilot Make Pilot Medel Smoke 8omb Pilot Timing 56 Seconda praft L.W. Cut Off Door Wiring .Tezf Tog S'PA .Lighring In:r. 1'eP Prossum 3,5°W,C. percentCO 7•0% Daro Testad 2' /19/75 Inpuf CFH 75 Parcant OZ $?7 Company Testing L ST IGHT CO Smck Temp???_Permnt CO 0? Name oi Testar Form 235 TALLED BY Sedgwick Htg, n u UNIT HTR. _OTHER IF-quest void 18 months from O a 7'- ``-'°"?r?'`y??j- 'R 1149 Date ?o?f?his Reques??? a I, as LA'Licensed Electrical Contractor? Owner, do heieby request inspection of the above electri- cal wfring installed at: Street Address or Route No. 17 O City? Section Township Range CountY'??ES¢??- Which is occupied by Is a roughin inspection required on this job? No ? Power Supplie[ Electrical Contractor Mailing Address !o Authorized Yes ? Ready Nowy Address Will Call ? t+_... 1t,r Contractor's License Nog-L° ? t or Phone No. n?? ?o f',l ?j'Q?? This inspecvon request will not 6e accepted by the el ti W a(r,l ? Lt? State Baard unless proper inspectian fes is enclosed. Minnesota State Board of Electricity 954'University Ave., St. Paul, Minn. 55104-Phone 645•7703 REQUEST FOR ELECTRICAL INSPECTION CHECK BELOW WOEtK COVERED BY THIS REQUEST /'z Od<,L h? 1149 Type of Building New Add. Rep. Check Appliances Wired For Check Equipment Wired Fot Home ? ? Range ? Temporary Wiring ? Duplex ? ? Water Heater ? Lighting Fixtures ? ApL Bldg. ? ? ? Dryex ? Electric Heating ? Commexcial Bldg. ? 0 0 Furnace ? Silo Unloader 0 industrial Bldg. ? ? ? Av Conditionei ? Bulk Milk Tank ? Farm List - - p her3? " ` j pList ereers? Othei ? a ? f? e 7 H COMPUTE 1NSPECTION FEE BEL Setvice Entxance Size: # F fcedeis: # Fee Ci[CUits: # Fee 0 to 100 Am s. 0 30 Am eres 0 to 30 Am eres ? 101 to 200 Ampa 31 to ]00 Am res 31 to 100 Am eres Above 200 Amps. ` Above ]00 Amps. Above 100 Amps. 'Iransformers RemoteControl Circ. Partial or ot Signs Special lns ection Minimum ee $5.00 Remazks 7'OTAL FEE Q I, the Electrical Inspector, hereby certify ihat the above inspection has been ma e. s. oU (Rough-in) Date (Final) _ ,1n„ ,J)Date 14 - `7 - > &' This request void 18 months from ?? O' 2007 RESIDENTIAL BUILDING PERMIT APPLICATION 0 City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 ( Q J Telephone # 651-675-5675 FAX # 651-675-5694 New Canstruc6on Reouirements 3 registered site surveys showirg sq. k. of lot, sq. ft. of house, and all roofed areas (20%maximum lot coverage allowed) 1 Soils RepoA d proposed bmlding is to be placed on disturbed soil 2 copies of plan showing heam & window sizes, poured found design, etc t set of Energy CalcNations 3 copies of Tree Preserva6on Plan A lot platted aRer 711193 Rim Joist DeWtl Optians selecdon sheet (bmltlinqs with 3 or less units) Mmnegasco mechanical veMilatbn fortn RemodellReoair Reauirements 2 copies of plan showing foohngs, beams, joisis 1 set of Energy Calculations for heated additwns 1 sde survey br addi6ons & decks Add'Rron - indicate ilwi-site septic system ofte use oorv Cert of Survey Recd _ Y_ N Sals Report - _ Y _ N TreePresPlanRecd _Y _N, TreePre'sRequired _Y. _N On-sAe Septic System _ Y_ N Plans are considered ublic information unless ou state the are trade secret and the reason. S q Da[e ( o `I - Constructian Cost ( r Site Address 1C?w 1'? 4? 1 UoiUSte # y V AOCf Lc^rtlt\-o. Q/ irf ? DescriptionofWork ?X r& . _ r Multi-Family Bidg X Y_ Fireplace(s) _ N 0 _ 1 _ 2 Telephone #IlI55' )u?? o' Property Owner Renewal By Andersen Contractor 1920 County Road C West Address Roseville, MN 55113 - ?ity State License #20130983 1'elephone # ( ) -- 651-764_4777 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateaorv I _ Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Cotle Worksheet (J submission type) Submitted Submitted • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master planB _ Y _ N If yes, date and address of master plan: Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone # ( Telephone # ( I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of M? Statutes; I understand this is not a pernut, but only an application for a permit, and work is not to start without k permit; that the work will be in accordance with the approved plan in the case of work which requires a review an< approyal of plans. iI n Applicant's Frinted Name Applicant's Signature DO NOT WRITE BELOW THIS LINE Sub Tvoes ? Ot Foundation ? 02 SF Dwelling ? 03 01 of _ plex ? 04 02-plex ? 05 03-piex ? 06 04-plex Work Tvoes ? 31 New ? 32 Addition 13 33 Alteration ? 34 Replacement 30 Axessory Bldg 31 Ext. Alt - Multi 33 Ext. AIt - SF 36 Multi Misc. ? 35 Int ImprovemeM ? 38 Demolish Interior ? 44 Siding ? 36 Move Building ? 42 Demolish Foundffiion ? 45 Fire Repair ? 37 Demolish Building• ? 43 Reroof ? 46 WindowslDoors •Demolition (Entire Bldg) - Give PCA handout to applicant DESCfiDtion: Water Damage _ ves Valuation Plan Review Census Code SAC Units # of Units # of Bldgs Type of Const ? 07 05-plex ? 13 16-plex ? 20 Pool ? ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4sea.) ? ? 10 08-plex ? 18 Deck ? 23 Porch (screen/gazebo/pergola) 0 ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 12 12-plex ? 25 Miscellaneous Occupancy MCES System 100°/a or _ 25% Zoning City Water Stories Booster Pump Sq. Ft. PRV Length Fire Sprinklered Width _ Footings (new bldg) _ Footings (deck) _ Footings (addition) Foundation Drain Tile Roof _ Ice & Water Final _ Framing _ Fireplace _ R.I. Air Test Final Insulation Approved By: Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total REQUIRED INSPECTIONS _ Sheetrock Final/C.O. Final/No C.O. HVAC Other _ Pool Ftgs Air/Gas Tests Final _ Siding _ Stucco Lath _ Stone Lath _Brick W indows _ Retaining Wal] Building Inspector Alili,i III, 3830 Pilot Kno6 Road Eagan MN 55122 Phone:(651) 675-5675 Fax: (651) 675-5694 ------------ I For Office Use - I Pertnit 430.16 ? ^,d fee: I% _ .. 'i I ? ? I ? Date Received.? 0' ? I I StaH: ? I `----------------- 2008 RESIDENTIAL PLUMBING PERMIT APPLICATION )ate: !5I Site Address: 'enant: 2ESIDENT / OWNER CONTRACTOR TYPE OF WORK , PERMIT TYPE I 'ES/DENT/AL FEES: Suite #: Name: ' . ?r1Y\ ?Qk l.a)D46K ' _Phone: llYfi-lR&-Wl Address / City / Zip: r1? Name: C1 3 tt=t 'Z> Y\LA vIW n e0 %,.a .",& ????•?? Address: k?nCICAJA i A"1- City: ? 1'1'L1 ?, State: " Zip: 5 V?` Phone: 40Contact Person: _ New 4- Replacement _ Repair _ Rebuild _ Modify Space ,_ Work in R.O.W. RESlDENTIAL ? Water Heater Lawn Irrigatlon RPZ / _ PV8) _ Septic System New Ahandonment _ Water Softener Add Plumbing Fixtures I Main _ Lower Level) W ater Tumaround 50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge) 30.50 Lawn Irrigation (includes $.50 State Surcharge) 50.50 Add Plumbing FiKtures, Septic System Abandonment, Water Turn@round' (inciudes $.50 State Surcharge) 'Water Turnaround (add $136.00 if a 5/8" meter is required) 100.50 Septic System New ($10.00 per as buiit) (includes County fee and $.50 State Surcharge) 30.50 Fire RepBir (replace bumed out appliances, ductwork, etc.) (includes $.50 Sta[e Surcharge) ? TOTAL FEES S ??? ' iereby acknowledge tha[ Nis mformauon is complete anC accurate; Nat the work wdl be in confortnance wrth the ortlinances and codes of the City of agan: that I untlerstand Nis is not a percnit, but onry an applicahon for a permit, and work is not to start vnNout a pertnrt: that Ne work wi0 be in ;cortlance with Ihe approved plan m[he case of work which requires a review and approval of plans. .. r X ? ? .? ?\ Il- l?F-?C Q.? ? Y A V6 WC \?Lu Xx-x ? Applicant's Signature R OFFICE USE fteviewed By: Date: I quiredlnspections: _UnderGround _Rough-In _AirTest _GasTest _Final GTTY OF EAGFlN CASHIER: JS TERMINAL N0: 338 DATE: 12/21/93 TIMF_: 10s47:59 ID: PtAPfEe MIKRE EX7Efi.T.OfiS 3210 9001 1724 FIICY.ORY HI 223.25 2155 9001 1724 HICY,OfiY HI 6.50 ToMal Receipt Amaunt: 229.'r'5 CR12i.440 lJSFR IDt JAN 1999 BUILDING PERMIT APPLICATION (RESIDENTIAL) a?? ?? 3 CITY OF EAGAN 3830 PILOT KNOB RD • 55722 651-681-4675 ewConstrucdon Reauirem ? 3 registered site surveys thowinp sq. R of bt, eq. R of houfe and all rooTed areas 120% maximum bt eoveraae allovwd) ? 2 copiea ot pWns (show 6eam 8 wlndow stzes; poured fnd. desipn; elc.) ? lceto(eneigycalculetiona D 3 copiea oTtrae preservadon plan H lot platled aPoer 7N193 DATE: I ?.. an _? DESCRIPTION OF WORK: erc??? 3? CONSTRUCTION COST: ? ? STREET ADDRESS: aq ) J? d`? " ( -? D, SY j) -? ?J O 1(-L o r V !4 I , i3 Ly L-l LOT: 1 4 ? BLOCK: ` SUBD.lP.I.D. #: a? Name: Phone #: PROPERTY last Ftrst OWNER Street Address: City State: Zip: (I'Ln u?1?"`/' ? V i e?-j I?LtS-6 rvA }-? Yl'1 e S ?+z a?o -dr ? ? Company: ? Phone 11: (area code) coHrRa,croR C}-{? e 1 2o I? 1-3 ?,° Street Addreas: ? L[cense # Exp. ?-? 0 C-) cicy EP?sT stace: 5v? N zip: ? 5 o ? l ARCHITECTI ENGINEER Company: Name: Telephone #: ( Street Address: Registrffiion tl: City Sewer 8 waEer Ifcensed piumber Inew wnsW edon onNl: State: Peilly appiles when address change and lot chanpe is requested once permit ia lssuad. I hereby acknorAedge that I have read this applicatlon, afate thffi the iirformatlon k corteet, and of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY Certificates of Survey Received _ Yes _ No RemodeVReoair Reauirements 2 wpiea of plan 1 sel of energy calculatfonn for heatad addMorrc 7 sHe survey tor extedor additbns S decks Zip: : Sfete of Minnesota Statutes and Cit r Tree Preservatian Plan Received - Yes - No - Not Required OFFICE U5E ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 06 4-plex ? 11 10-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 02 SF Dwelling O 07 5-plex ? 12 12-plex ? 17 Garage ? 22 Porch/Addn. (4sea. ? 03 1 of _ plex ? 08 6-plex ? 13 16-plex ? 18 Deck ? 23 Porch (screened) ? 04 2-piex ? 09 7-plex ? 14 Apartments ? 19 Lower Level ? 24 Storm Damage ? 05 3-plex ? 10 S-plex ? 15 Lodging ? 20 Pooi ? 25 Miscellaneous WORK TYPE ? 31 New ? 35 ? 32 Addition ? 36 ? 33 Alteration ? 37 ? 34 Repair ? 38 GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Width APPROVALS Planning Tenant Impr ? 39 Gas Line Only ? 43 Siding/Soffits/Fascia Move Bldg. ? 40 Gas Insert ? 44 Windows/Doors Demolish Bldg.• ? 41 Wood Stove ? 45 Fire Repair Demolish (Interior) ? 42 Reroof • Give PCA handout to applicant for demolition permit Basement sq. ft. Main level sq. ft. sq. ft. sq. ft. sq.ft. sq. ft. Footprint sq. ft. Building Engineering Census Code SAC Code No. of Units No. of Bldgs MC/ES System City Water Booster Pump PRV Fire Sprinklered Variance Permit Fee Surcharge Plan Review License MC/ES SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Park Ded. Trails Ded. Other Copies Total: Valuation: $ SAC Units '/o. SAC cxrv nr- rnc?N C'AiHTE:f:: JS 1FRMINAL N.O. 718 L1A'fE:a 07/16/99 rIMI..: j.1): 53°.2i IBr.. NAt1E: , ADLiF"Ci V6tI_UF E.XTEFIORSy INC. 3210 9001 1657 FIICF:pPY 1-11 199.25 2155 9001 1G57 41ICY.[]CtY HI :3,50 321.0 9001. 1665 1-17:Cf.GRV HI 1.39.25 21.55 9001 1.665 NIC;F:pFiY FI:1. 3.50 32i.0 9001. 1708 N.T.GI;GhY HI l39.25 21.;i5 900:1 1.708 NTf.;t:CtliV HI 3.50 :121.0 9001 1.724 H'f.f:F.0RY HI 139.25 2l:55 ')QD'I. 1724 H7C}:LlfiY N.T. 3.50 3214 901:11 1641. IIICKOf.Y L,A 139. ?5 21.`?5 9I101 1641. HSLI:UfiY LA :3.50 Cfi1.i3489 ** L:ON'1'TNUE I.)SF'fi rrt: ,IqN 0 CCiN'fINUE X??k??k%? ?k? X? kt%C?X ?Xcik?t Xtm?C X?t6 #?k?7nk:?k h?#X?%?X?Xok?k%ka??kkCAc [:(JN7TNUF. CITY C)F CFlGAtd CASHICh': 1S T'I:RMINAL NrJ: i 18 DATE- 0'r'/1ib/199 'i'2ME° W;53c22 ITi e • NAMG: ALtIiELi VAt_t.ll= EXTCfiI(7RSy TNC. 3210 9001 1676 HICF;UfiY L_F1 139.25 21.'35 900:1. 1676 NICY.01'yY l.Ft :3.50 i Toka:L keceipt Amoi.eni;: 856.50 CF;:I.13489 4JSL.R IU: JAN 'lyyy BUILUIN4 F+tKMI"1 NPPLICATIUN IRESIDENT1ALl CITY OF EAGAN 3830 PILOT KNOB RD • 55122 651•681-4675 New Conslructlon ReauiremeMs Remodel/Reoair Reavhemenh D 3 regMered slte suneys showing sq. H. of lot, sq. k. of house and gg roo(ed areas [20% maximum lot eoveraae atlowed) D 2 coples of plana (show baam 6 window aher, poured tnd. dealgn; efe.) D 1 fel of energy talculatlons D 3 copies W hee presenatbn plan C lot pWMed aHer 7/1/93 DATE: -1 "I S` DESCRIPTION OF WORK: / 7c-q? ?i17 STREET ADDRESS: ? e c-?<c? '`i LOT: 5 BLOCK: '1 w -L? SUBD./P.I.D. #: W ID- PROPERTY OWNER CONTRACTOR ARCHITECT/ ENGINEER ?4? S6 A??" Phone #: Lad fhsf Sheet Addreu:? 6`? r f1 l ?? CL Cify cqcc-t- state: 14it'"1- zlp: S!Z-/ 2Z- Company: +C? (' &LLL?- "r'is? ?r-?tea-S rhone e: C S l-C4 53 (area code) SfreetAddreu: ?7 ?lb?ha? 41?C? MA(C-'-' LicenseA?2?21?Exp• ?? cny t¢,? sf'P,-fPl 2 copks W plan 1 set ot energy calculaNons lor healed addHions 7 aMe funey br exfedor addHlons i deCW i?r??l ./{ 7 (J/ ri "f' CONSTRUCTION COST: staFe: ?.?•.- ziP: S S/ t' g' Company: Name: Telephone k: area code ( Stree't Address: RegishaFion 8: City Sfate: Sewer 6 water Ifcensed plumber (reaulred tor new conshueNon onNi: Zip: PenaNy applles when cddress chonge and lot change h requested onee permN is issued. I hereby acknowledge thaf I have read this oppllcaNon, stote that the InformaNo Is ef, d a ree to tomply wMh all applicabl Stale of Minnesota Stofutes and CMy 01 Eagan Ordinances. Slgnature ot Appllcanh • OFFICE USE ONLY f- - -- Certficates of Survey Received _ Yes _ No I( ??/)`$?l• +??., ,, Tree Preservation Plan Received _ Yes _ No _ Not Required a . . PERMIT ce06'66-05 CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Eagan, Min nesota 55122-1897 Permit Number: 027501 (612) 681-4675 Date Issued:. 0 5/ 0 8/ 9 6 SITE ADDRESS: 1726 , HTCKORY WILL LOT: 4 BLOCK: 2 WOODGATE 2ND P.I.N.: 10-84601-040-02 DESCRIPTION: 01_^,?, (GAS LINE & INSERT) Buil"di4.,'Permit Type FIREPLACE jf8u_iltl3,mg. 4ork Type ALTERA7ION Car?sus: CoEfe 434 ALT. REBTDENTIAL i IE.? .. . ., . ` . 1 , . . , -..'t C. v.i - ? r uY -? REMARKS: FEE SUMMARY: Base Fee $25.00 Surcharge $.50 Total Fee $25.50 CONTRACTOR: - A p p 1 i c a n t- OWNER: HEARTH SERVICES INC 17509815 PIONTEK DAN 6693 E SHADOW LAKE DR 1726 HICKORY HILI LINO LAKES MN 55014 EAGAN MN (612) 750-9815 (612)686-5390 IL I her`eby a6knowledge Ehat Y have read this applicationand stete that the inFormation 3.s ao?rect and"agree to compl'y ui`th ail epplicable State of Mn. Statufies ahd'°CYty'- of ga§an Ordinanoes. ' ,SSUEDB SR AT? I m.ri APP GANTlPERMIT IG RE CITIf OF EAGAN 3830 PILOT KNOB RD - 55122 7996 FIREPLACE PERMIT APPLICATION 681 -4675 DATE: ? ?- ?- %(42 DESCRIPTION OF WORK: _ INSTALL 1M FIREPLACE: WOOD BURNING INSTALL GAS LOG ONLY IN EXISTING FIREPLACE `-Y {--? C ..J D GAS INSTALL GAS LINE ONLY IN EXISTING FIREPLACE X OTHER: ; vL e-)6j? AREA TO BE INSTALLED IN: STREET ADDRESS: . LOT ? BLOCK ? SUBD./P.I.D. #: APPLICANT: (circle one only) OWNER I hereby acknowledge that I have read this application and state that the information is corcect and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. PROPERTY OWNER FIREPLACE INSTALLER cns uNe INSTALLER ? Name: k, ? ?l ! e l? EK: ??1 Phone #: - 32 u.. ?.. Signature: Street Address• City: Company: Phone #: Signature: Street Address: License #• Cfty; State: Zip. Company: 4 m-n"k t5 ?ek''V'Ces 1'K(-Phone #• ' 75b -'9e/ ;-- Name: SignatL r Street Address, &,P4 0 7 -? ?- • ?' ?'"`?x'' w ?" ^" • ' City: L, )N\ ) _ A&s State: ? Zip: State: Zip: OFFICE USE ONLY BUILDING PERMIT TYPE 0 14 Fireplace WORK TYPE 0 31 New 0 32 Addidon 0 33 Alteratlons 0 34 Repair GENERAL INFORMATION Census Code. SAC Code REMARKS: Chimney/flue must be inspected before coneealing. ? r FEES Pertnit Fee Surcharge Other Copies Total: L'7:TY fjF C:AGAN CASH:1"E:Fi: '; 1'E.FtMTnAI. N0: 89111. DAi::" 04/L?/99 Y1MEi 0120M TD ; Nf1MF;: Fdl._I..LED rIRF::4.i:CDE INC 205, `-"OUS t':3:7 1°I.LC'KORY HL.. 0.50 3c?ip 9001 030 bL[r;14:)R`I 4lI. 6[].00 1'nl,a1 Re.t:cipt Afiipltf7l;Y L(? ?50 rh i U i'486 1.!Sl-1i II1^ PIANCY .. .5?0.s-0 _3 S ? ? S7 1999 FIREPLACE PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD - 55122 (651) 681-4675 Date: Am IC 1 42*, Ge i Description of Work: %5- Construct reew tireplace 7y Install Qas insert or:lv _ Other Job address: Lot: ? _ Alterations to existing _ Install Lyas line onlv Block: ?- Subdivision/P.I.D. #: w(°1 Applicant (circle one only): Owner Contractor Name: l I a yI.S LO{1 ?fCt G f.y----- PROPERTI' ast First OWNER /?)J O "1 II rgn?/ Street Address: ? ? ? FIREPLACE iNSTALLER GAS LINE IPISTALLER Permit Fee: 560.50 Phone #: ki- ps--ag4 t City Stare: Zip: Company: 1? E f (? ?'11?VI?N I Phone#: City State: ? Zip: -!2-;-J'37 Street Address: Company:_ Street Address: City Zip: i hereby acknowled-e that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City oF Eagan Ordinances. n t nn Z,4/ n 4 Phone #: State: Signa[ure L? ' OFFICE USE ONLY BUILDING PERM[T TYPE ? 14 Fireplace WORK TYPE ? 31 New ? 33 Alterations ? ? 32 Addition ? 34 Repair GENER4L INFORM.4TION Census Code. 434 SAC Code 01 RF.NIARKS Chimney/flue must be inspected before concealing. . ryDm -TJ; -3d- L A o f E c?m ? _!'i ??.?-aQ/_ ? ? ?(0 . _5?__5 C?r?,n sbof-o ?r. _ -- 1?30? cK?Y-\jN; -.-- L --?------------- --- ? ? ----...--- ----------- __- S.c?.-TesY??.- ------- -- -------------- --._ __ _. -- ?1"- r,d LzcYjj -- f 'R. Or 3830 PILOT KNOB ROAD. P.O. BOX 21199 BEA BLOM9UI57 EAGAN. MINNESOIA 55121 ^^? PHONE: (612) 454-8100 DATE : pugu st 20. 1985 THOMAS EGnN JAMES A. SMI7H JERRV THOMAS ADDRESS: 1724 Hickory Nill 7HEODOREWACHTER Couricd Members LEGAL DESCRIPTION: Lot 3- Block 2 c"mM,?am?:° aEs EUGENE VAN OVERBEKE Wood gate 2nd Addition a"ycmrk Dear Eagan Resident : RE: RIGHT-OF-WAY/BOULEVARDS - CITY PROPEftTY It has been brought to the attention of the Public Works Department that you have placed a structure or obstruction on the City right- of-way in violation of the City Ordinance referenced below. CITY ORDINANCE SEC. 10.32. OBSTRUCTIONS ON PUBLIC PROPERTY Subd. 1. Obstructions. It is unlawful for any person to place, deposit, display or offer for sale, any fence, goods or other obstructions upon, over, across or under any public property without first having obtained a written permit from the Council, and then only in compliance in all respects with the terms and conditions of such permit, and taking precautionary measures for the protectibn of the public. An electrical co=a or device of any kind is hereby included, but not by way of limitation, within the definition of an obstruction. Subd. 6. Continuing Voilation. Each day that any person con- tinues in violation of this section shall be a separate offense and punishable as such. ' SEC. 11.1. GENERAL PROVISIONS Subd. 9. Structures in Public Right-of-way. No buildings, structures or uses may be located in or on any public lands or Right-of-Way without approval by the Council. The public right-of-way or boulevard is that area from the curb to your property line (approximately 13 feet) and is intended solely for utilities and snow storage. The structure must be removed from this boulevard area to provide for required storage and also to protect our snow removal equipment from damage. We apologize for THE LONE OAK TREE. .. THE SYMBOL OF STRENGTH AND GRONRH IN OUR COMMUNIiV l - RIGHT-OF-WAY/BOULEVARDS - CITY PROPERTY PAGE 2. the inconvenience this relocation may create, but it is necessary to prevent damage to your structure and also to our snow removal equipment. The only exception to the ordinances are mail boxes if they are installed according to Federal specifications as furnished by the post office. A copy of this letter notifying you of this violation will be placed in your parcel file with a copy to the appropriate enforcement division. THEREFORE, YOU ARE HEREBY NOTIFIED TO HAVE THE VZOLATION CORRECTED AND THE OBSTRUCTION REMOVED WITHIN 60 DAYS OF THE DATE OF THIS LETTER. After that time, you will be subject to the fines as stipulated in this ordinance. The City of Eagan cannot accept any responsibility for damage that may occur to those obstructions that are in violation of the City Ordinance. If you have any questions, please feel free to call me at 454-5220. Yours truly, william H. Branch, Superintendent Public Works Department WHB:jbd ! Rocks on the boulevard ? -9-032 2005 RESIDENTIAL MECHA1vICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for. single family dweliings &[ownhomesJcondos when permits are required for each uni[ $ ;0 .s(o Date oJ Site Address ? -7a (944 i 4tl ty- • Unit # Telephone # (?5l A)86Y -'),3qO Praperty Owner Contractor Wohlers Southside Htg. & Air, Inc Street Address I, - 6950 W. 146w St., 4106 Apple Valley, MN 55124 I I City I (952) 431-7099 State li Telephone #( ) Bond #: T-L-=0 4-79 2)'7` Expires: s,-")5- - d(° The Appticant is _ Owner ? Conhactor _ Other Add-on or alteration to existing dwelling unit $ 30.00 furnace _Additional )-Replacement air exchanger ?- airconditioner _New ??Replacement other State Surcharge $ 50 $??_? Total I hereby apply for a Residential Mechanical Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the Ciry of Eagan and with the Mechanical Codes; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Applicant's Printed Name L-?Applicant's Signature 2005 COMMERCIAL MECHANICAL PERMIT APPLICATION City OfEagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for. commerciai/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit Date Site Street Address Unit # Tenanf Name (if applicable) Previous Tenant Name Property Owner Telephone # ( ) Contractor Street Address City State Zip Teiephone # ( ) Bond #: Expires: The Applicant is Owner Contractor Other Work Type _ New Construction _ Underground Tank _ Install _Remove **see below _ Interior Improvement _ Install Piping _ Processed _Gas Natura of Work: 'When installing/removing underground tank, call for inspection by Fire Marshal and Plumbing Inspector Permlt FeeS: 570.50 Underground tank installation/removal . 550.50 Minimum (includes State Surcharge) or Contract Value $ x 1% _ $ Permit Fee • If ermit fee is $1,000 or less, add $.50 => $ State Surcharge If en rmit fee is over $1,000, add $.50 for every $1,000 oe rmitfee $ Tatal Fee i nereoy appiy ror a commerciai Mechanical Permrt and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the Ciry of Eagan and with the Mechanical Codes, that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Applicant's Printed Name Applicant's Signature Approved By: , Inspector Date: 2006 RESIDENTIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dweilings. /?-110 Date?3/?3_! 01 Site Street Address a, ? ffiCLOCLA U2 N Or' Unit # Property Owner PQ,n hbh WK- 5( ) (08 ?" '?? 3`?c ? Telephone # ( 0 Champion Contractor 651-385-1340 Telephone # ( Address 3670 9 City State Zip The Applicant ls: _ Owner ?OContractor _ Other Septic System _ New _ Refurbished Submit 2 sets of plans and MPC license Includes County fee $ 100.00 Per as-built - $ 10.00 Alterations to existing dwelling $ 50.00 _ Add plumbing fixtures. This fee includes installation of a water softener and/or water heater at the same time. If you are Fnsfalling onlv a water softener and/or water heater, do not complete this section; move to the neut s on and check the appliance(s) you are installing. 9 ?'. ?^ C L7 qp f- r? i _Septic System Abandonment A ?G 1 J " 3 2007 _ Water Tumaround (add $130.00 if a 5/8 meter is required) Other: Water Softener '>QWater Heater $ 15.00 new ?replacement ' _ - Lawn Irrigation _RPZ _PVB _new _repair _rebuild $ 30.00 State Surcharge $ .50 l $ 5 5d Tota I hereby appiy for a Residentiaf Plumbing Permit and acknowledge that the information Is complete ana accurate; cnat [ne work will be in conforrnance with the ordinances and codes of the City of Eagan and the plumbing codes; that I understand this is not a pertnit, but only an appiication for a permit, work is not to start without a permit and work will be in accordance with the approved plan in the event a pian is required,tp be reviewed and approved. ApplicanYs Printed Naine ' i Applicant s Sighature ?2 5 qqo U? Use BLUE or BLACK Ink --------------i 1 For Office Use 1 I I 1 Permit V 1 City of kdn Permit Fee: (0 U 3830 Pilot Knob Road j 1 Eagan MN 55122 i Date Received: Phone: (651) 675-5675 Fax: (651) 675-5694 I Staff: Cl 2012 MECHANICAL PERMIT APPLICATION Date: Site Address: 1724 4ft c / Hla~s ~ Tenant: ,~r~c Suite 7r? -T X RESIDENT / OWNER Name: p1AAJ C--G= W VQC"'(64145068& no I Address / City / Zip: l qG4r rGf f~"' if ~7LL y"Tr~i v ° /l.~N L zz Name: Ceti ~JJ-7/ ucalticense CONTRACTOR Address: c_02- 1 44tilvaw city: State: Zip: Phone: ,-7(41) Contact: MIK-2-- LUT; Email: l ~ e-45, 1 ACam` New Replacement Additional Alteration Demolition TYPE OF WORK Description of work: NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector for information on permitted screening methods. RESIDENTIAL COMMERCIAL Furnace New Construction - Interior Improvement PERMIT TYPE - Air Conditioner - Install Piping - Processed Air Exchanger Gas Exterior HVAC Unit - - Heat Pump Under / Above ground Tank Install Remove) Other RESIDENTIAL FEES: $60.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) 00 $100.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) TOTAL FEE COMMERCIAL FEES: $75.00 Underground tank installation/removal (includes $5.00 State Surcharge) OR Contract Value $ x1% $60.00 Minimum (includes State Surcharge) Permit Fee - if the Permit Fee is less than $10,010, surcharge is $ 5.00 Surcharge - If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee (i.e. a$10,010-$11,010 Permit Fee requires a $ 5.50 surcharge) TOTAL FEE CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.goaherstateonecall.ora hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x x Applicant's Printed Name Applicant's Signature FOR OFFICE USE Required Inspections: Reviewed By: Date: Underground Rough In Air Test Gas Service Test In-floor Heat Final HVAC Screening r For Office Use 75-xqeir a a a P:::tco: #: EAGANP :rT I ece'VE Date Received: �,�� 3830 PILOT KNOB ROAD EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)6 gp� Staff: —yea buildinginsnections(acityofeagan.com Fit'1� 1 7 2019 2019 RESIDENTIAL igi _ - MIT APPLICATION 17- 1`� / 7c 6/ I-II-icjCvey }� I72� / /73Z� Date: Site Address: ! Unit t#,:� -7 Name: WOO di Gti e 47"e°Vita A-ss OC:01'{ O I Phone: 65/ l 511.73 Y7 Resident/ ./ / 7( H . cicor (1 or Eay 4 l� S,S 1024 owner Address/City/Zip: Y Applicant is: Owner X Contractor Type of Work Description of work: ' `� ' "`'Qf l Qv' O. ctribt ? lace Construction Cost: 0/‘ Building: (Yes A /No ) Company:y ""d rPvi n QQ<'0��-tr.S �^frac-177y tact: Qye &irr►�igdrl R h D ContractorAddress: / 1 5-73 FOX 4671) City: 1=arr1• hi State:11 Zip: 16r0�-Sq 9'Via? Phone: Email License#: 6C /700 6 (1 Lead Certificate#: If the project is exempt from lead certification, please explain why: 61 n No l�'a; a1 r-oar. COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months,has the City of Eagan issued a permit for a similar plan based on a master plan? Yes No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: Fire Suppression Contractor: Phone: NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of the Infotmahon may be classified as non-public If you provide specific reasons that would pert the City to conclude that they are tirade secrets. You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeaaan.com/subscribe. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.aoaherstateonecall.orq I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approva of ans. x ,SfereSorrl ctr i l Applicant's Printed Name Applicant's Signat re ��